Reviews

Antiviral treatment for preventing postherpetic neuralgia
There is high quality evidence that oral aciclovir does not reduce the incidence of PHN significantly. In addition, there is insufficient evidence to determine the effect of other antiviral treatments; therefore, further well-designed RCTs are needed to investigate famciclovir or other new antiviral agents in preventing PHN. Future trials should pay more attention to the severity of pain and quality of life of participants, and should be conducted among different subgroups of people, such as people who are immunocompromised. Chen N, Li Q, Yang J, Zhou M, Zhou D, He L. Cochrane Database Syst Rev. 2014 Feb 6;2:CD006866. [Epub ahead of print] PMID: 24500927

The pharmacogenetics of type 2 diabetes: a systematic review
We found evidence of pharmacogenetic interactions for metformin, sulfonylureas, repaglinide, thiazolidinediones, and acarbose consistent with their pharmacokinetics and pharmacodynamics. While high-quality controlled studies with prespecified analyses are still lacking, our results bring the promise of personalized medicine in diabetes one step closer to fruition. Maruthur NM, Gribble MO, Bennett WL, Bolen S, Wilson LM, Balakrishnan P, Sahu A, Bass E, Kao WH, Clark JM. Diabetes Care. 2014 Mar;37(3):876-86. doi: 10.2337/dc13-1276. PMID: 24558078

Low dose naltrexone for induction of remission in Crohn's disease
Currently, there is insufficient evidence to allow any firm conclusions regarding the efficacy and safety of LDN used to treat patients with active Crohn's disease. Data from one small study suggests that LDN may provide a benefit in terms of clinical and endoscopic response in adult patients with active Crohn's disease. Data from two small studies suggest that LDN does not increase the rate of specific adverse events relative to placebo. However, these results need to be interpreted with caution as they are based on very small numbers of patients and the overall quality of the evidence was rated as low due to serious imprecision. Further randomized controlled trials are required to assess the efficacy and safety of LDN therapy in active Crohn's disease in both adults and children. One study is currently ongoing (NCT01810185). Segal D, Macdonald JK, Chande N. Cochrane Database Syst Rev. 2014 Feb 21;2:CD010410. [Epub ahead of print] PMID: 24558033

Military aircrew and noise-induced hearing loss: prevention and management
Modern-day high performance aircraft are more powerful, more efficient, and, unfortunately, frequently produce high noise levels, resulting in noise-induced hearing loss (NIHL) in military aircrew. Military pilots are required to perform many flight duties correctly in the midst of many challenges that may affect mission completion as well as aircraft and aircrew safety. NIHL can interfere with successful mission completion. NIHL may also require aircrew to be downgraded from flying duties, with the incumbent re-training costs for downgraded personnel and training costs for new/replacement aircrew. As it is not possible to control the source of the noise without compromising the efficiency of the engine and aircraft, protecting the aircrew from hazards of excessive noise and treating NIHL are of extreme importance. In this article we discuss various personal hearing protection devices and their efficacy, and pharmacological agents for prevention and management of NIHL. Rajguru R. Aviat Space Environ Med. 2013 Dec;84(12):1268-76. Review. PMID: 24459798